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Millersville University Campus Recreation Office INTRAMURAL STAFF APPLICATION TERM APPLIED FOR: Fall Spring DATE OF APPLICATION: ______/_______/_______ Job (s) of Interest: _____ Official/Referee ______Scorekeeper (limited to certain sports & limited spots available) NAME: __________________________________________ MU # M00_________________________________ Have you worked on campus in the last 6 months? Yes No If yes, what department? ____________________________ CURRENT CAMPUS OR LOCAL ADDRESS: (Campus Address, include room & box# & Local Address, include city & zip code) ______________________________________________________________________________ ____________________________ LOCAL PHONE # _____________________________ CELL: # ___________________________________ E-MAIL ADDRESS ______________________________________________________________________________ AIM / AOL SCREEN NAME ______________________________________________________________________________ PERMANENT ADDRESS ______________________________________________________________________________ ______________________________________________________________________________ PERMANENT PHONE # ________ _____________________ CURRENT MU CLASS Freshman _____ Sophomore ______ Junior _____ Senior _______ Graduate _______ ANTICIPATED GRADUATION DATE: Please provide a year with the listed semester: Fall ________ Spring _________ CURRENT MAJOR ______________________________________________________________________________ PRIOR RECREATIONAL OR EQUIVALENT EXPERIENCE:

Millersville University · Web viewMillersville University Campus Recreation Office INTRAMURAL STAFF APPLICATION TERM APPLIED FOR:Fall SpringDATE OF APPLICATION: _____/_____/_____

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Page 1: Millersville University · Web viewMillersville University Campus Recreation Office INTRAMURAL STAFF APPLICATION TERM APPLIED FOR:Fall SpringDATE OF APPLICATION: _____/_____/_____

Millersville UniversityCampus Recreation Office

INTRAMURAL STAFF APPLICATIONTERM APPLIED FOR: Fall Spring DATE OF APPLICATION: ______/_______/_______

Job (s) of Interest: _____ Official/Referee ______Scorekeeper (limited to certain sports & limited spots available)

NAME: __________________________________________ MU # M00_________________________________

Have you worked on campus in the last 6 months? Yes No If yes, what department? ____________________________

CURRENT CAMPUS OR LOCAL ADDRESS: (Campus Address, include room & box# & Local Address, include city & zip code) ______________________________________________________________________________ ____________________________ LOCAL PHONE # _____________________________ CELL: # ___________________________________

E-MAIL ADDRESS ______________________________________________________________________________

AIM / AOL SCREEN NAME ______________________________________________________________________________

PERMANENT ADDRESS ______________________________________________________________________________

______________________________________________________________________________

PERMANENT PHONE # ________ _____________________

CURRENT MU CLASS Freshman _____ Sophomore ______ Junior _____ Senior _______ Graduate _______

ANTICIPATED GRADUATION DATE: Please provide a year with the listed semester: Fall ________ Spring _________

CURRENT MAJOR ______________________________________________________________________________

PRIOR RECREATIONAL OR EQUIVALENT EXPERIENCE:

WHY DO YOU WANT TO WORK IN THIS POSITION?

REFERENCES: Please include name, current contact number or email address

1. _______________________________________________________________________________________________________

Page 2: Millersville University · Web viewMillersville University Campus Recreation Office INTRAMURAL STAFF APPLICATION TERM APPLIED FOR:Fall SpringDATE OF APPLICATION: _____/_____/_____

2. _______________________________________________________________________________________________________

3. _______________________________________________________________________________________________________